Preeclampsia Hypertensive Disorders in Pregnancy

Major breakthroughs in preeclampsia research have resulted from a collaboration between the Department of Obstetrics and Gynecology and the Department of Medicine at Beth Israel Deaconess Medical Center. Preeclampsia affects 200,000 pregnancies each year in the United States and often leads to premature births. It complicates 5% of all pregnancies, and severe preeclampsia is one of the world's leading causes of maternal and fetal mortality.

The BIDMC OB/GYN collaborative research team has discovered key pieces of evidence to help diagnose and eventually treat this disease. The researchers first found that a molecule that naturally occurs in the placenta, called sFlt-1, may cause the maternal syndrome when it is overabundant. Further research in a collaboration with The Hospital for Sick Children in Toronto, discovered that a second protein, soluble endoglin, when combined with sFlt-1escalates preeclampsia to a severe life-threatening state. This work has led to BIDMC patent filings on methods of diagnosing and treating preeclampsia.

BIDMC researchers are testing the hypothesis that these two molecules can be used as biomarkers in various clinical settings as a helpful tool for clinicians to make a more prompt and accurate diagnosis of preeclampsia. Prospective studies are currently ongoing; and although drug-based therapies for preeclampsia may still be years away, researchers are optimistic.

Other preeclampsia research includes an NIH-funded investigation to evaluate the pathogenesis of the excess cardiovascular disease noted in women with a history of preeclampsia. The investigators are working on non-invasive techniques to evaluate pregnancy in an animal model of preeclampsia. A BIDMC OB/GYN researcher is also co-leading a multi-center randomized controlled clinical trial across several hospitals in the United States and Canada evaluating the role of optimal blood pressure management for patients with hypertension in pregnancy. This research program is directed by renal specialist S. Ananth Karumanchi, MD, Howard Hughes Medical Institute Investigator; in collaboration with Maternal-Fetal Medicine specialist Sarosh Rana, MD.